Otogenic Pneumocephalus Associated with a Ventriculoperitoneal Shunt

김영훈; 이원일; 박미나; 한수진; 김나현

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자료유형: 학술저널

저자정보: 김영훈 이원일 박미나 한수진 김나현

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제2권 제4호

발행연도: 2009.1

수록면: 203 - 206 (4page)

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Otogenic pneumocephalus is a condition of intracranial air originating from the middle ear or mastoid air cells. This communication between the intracranial cavity and the pneumatic cavities is usually associated with trauma after cranial fractures or iatrogenic trauma. We present a rare case of otogenic pneumocephalus arising in the left posterior fossa from wellpneumatized mastoid air cells. The patient complained of roaring tinnitus that developed 29 months after ventriculoperitoneal shunt insertion due to brain tumor surgery. High resolution computed tomography scan of the temporal bones revealed a large pneumocephalus below the left tentorium, and a bony dehiscent route was clearly identified in a sagittal view. A left mastoidectomy with preservation of the posterior wall of the external auditory canal was performed, and the expected bony dehiscent site was identified in the posterior fossa dura plate, just posterior to the posterior semicircular canal, below the Donaldson’s line. This communication was sealed with a temporalis muscle plug from the deep temporalis muscle fascia and bone dust. Pneumocephalus may be caused by negative intracranial pressure in a patient with very well-pneumatized mastoid bone, and it can be a possible cause of ‘wind-like’ sound in the ear.

#Pneumocephalus #Ventriculoperitoneal shunt

참고문헌 (9)

참고문헌 신청

Andrews JC / 1986 / Otogenic pneumocephalus / Laryngoscope 96 (5) : 521 ~ 528

Anorbe E / 2000 / Spontaneous pneumatocele and pneumocephalus associated with mastoid hyperpneumatization / Eur J Radiol 36 (3) : 158 ~ 160

Chan EK / 2007 / Otogenic tension pneumocephalus caused by therapeutic lumbar CSF drainage for post-traumatic hydrocephalus: a case report / Ear Nose Throat J 86 (7) : 391 ~

Honeybul S / 2006 / Delayed pneumocephalus following shunting for hydrocephalus / J Clin Neurosci 13 (9) : 939 ~ 942

Kanner AA / 2000 / Spontaneous pneumocephalus in the posterior fossa in a patient with a ventriculoperitoneal shunt: case report / Neurosurgery 46 (4) : 1002 ~ 1004

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